Sashimi – keto friendly, full of good fats and protein, good for brain health. (Skip the rice.)

The keto diet and ADHD symptoms and Quora

I try to be active on Quora because I think it's a good way to position myself as an expert on ADHD. I've had several people specifically request my answer to questions. Since the keto diet has helped me manage ADHD symptoms, I felt absolutely qualified to answer the following question in July:

“How has the keto diet affected your ADHD symptoms?”

I have a whole keto series in progress for this blog, but here's how I answered:

Even before I knew about the “keto” diet, I was following something like it, and have been for over 20 years. The most impactful thing I’ve done to manage my ADHD is to consume more fat. The brain NEEDS fat. For this reason, I recommend that people with ADHD try the keto diet, or something close to it. (Modify as needed. Your mileage may vary.)

A medically-controlled version of the ketogenic diet that involves measuring food and nutrients has been used to treat epilepsy and other neurological disorders for decades.

Some people with ADHD benefit from the intermittent fasting aspect of ADHD too. It’s something worth testing out. We do tend to need regular fuel with fat and protein but if IF works for you, then do it. I think that IF is more for people who do the keto diet for weight-loss, as IF forces the body to use fat for energy.

The key is to experiment, listen to your body and see what works. When you find what works, stick with it.

That's not me, but it could be. The stock image model is not driving a stick shift, either. Photo by Element5 Digital on Unsplash

This post is an excerpt from a story that I published on Medium. The original was called, “Adventures in Stick Shift Driving: An ADHD story”. The original is a 14-minute read and is about my history of driving; the decades that I avoided driving due to fear doubt and lack of confidence and about recently learning to drive a car with a manual transmission, aka stick shift.

The ADHD brain and driving

People with ADHD could have a higher risk of getting into an accident.

There are some things that I’ve realized during my adventures in learning to drive. I probably should have recognized these years ago, given that I didn’t know that I had ADHD until I was in my early 20s.

My ADD contributed to my driving anxiety in many ways. My spacial awareness and executive function made driving a challenge.

The ADHD brain tends to get stuck on stories. I make one driving mistake, and I obsess over it rather than move on so that I can focus on the rest of the drive.

The anxiety makes me forget things. I panic. When I first started my post-lesson practice, I forgot how to specific steps. My stick shift driving instructor warned me this could happen.

I’ve read a bunch about ADHD and driving, mostly articles for which the parents of teenagers are the target audience.
A lot of the advice makes sense. Some of the usual advice:

Limit distraction. —

Don’t listen to music or the radio

Don’t make or receive phone calls, even hands-free

No texting (it could be against the law where you live anyway)

Keep your hands off the GPS.

Limit the number of passengers in the car. —

One person can be a helpful co-pilot, but more can be a distraction

Enroll in a defensive driving course. —

I’ve now done this twice (age 16 and recently) and honestly, I think that everyone should take one every decade or so as a refresher.

Use cruise control —

Use cruise control when driving above a certain speed. I think it makes the most sense on long stretches of highway.

I want to add this piece of advice:

Make sure you're adequately rested before you drive. If you have an early day, go to bed early. Being tired is a risk to all drivers whether they're neurodivergent or neurotypical. There's a reason that rest stops for truckers exist. Tiredness increases the likelihood of losing focus and making mistakes – for anyone.

Driving stick shift

In the months before I got behind the wheel for my formal stick shift driving education and before I decided to take the lessons, I listened to an ADDitude magazine podcast about teaching teenagers to drive.

It was an interview with a psychologist. He advised that people with ADHD shouldn’t drive cars with manual transmission and should only buy cars that are automatic. Although I’d been resisting driving my boyfriend’s car, this statement felt like poor advice. I read this expert’s advice two more times in two different articles. It never felt right.

I’ve known a small number of people who drive stick. A few of those have ADHD and love driving stick shift. I can see why, and I can see how driving stick is better for the driver with ADHD after lots of practice. Several articles that I read after I started driving again (all anecdotal) support this. Here are my observations:

The ADHD brain and driving stick

You need to pay attention. Some might refer to this as a reason to not drive manual. I think it’s a reason to.

It’s too easy to tune out and go on “autopilot” when you’re driving a car with an automatic transmission.

It’s too easy to allow distraction.

Stick shift cars require focus at every moment and every action. It’s not just that you need to watch out for pedestrians and vehicles. You need to learn to drive with two feet. You need to shift up and down, finding the right gears without looking. You stop on hills (even gentle slopes) and maintain the stop by finding the right friction point on the clutch while also lightly pressing the gas.

It’s a lot to remember.

Not listening to the radio is an attention issue; as in, don’t let your attention drift to where it doesn’t need to be.

Silence in the car also makes it easier to hear the engine. With a manual transmission, the engine “talks” to you and helps you drive. It tells you when you need to change gears, when you’re in the correct gear, and when you need to press on or lift the clutch.

I listen to the gear shift: Without looking, I can hear when the shifter has clicked into the gear as opposed to not entirely being locked in. There's a specific sound that the gear shift makes when it clicks into Reverse, and that sound confirms that I’ve clicked into Reverse gear rather than 4th gear or 1st, depending on where Reverse is located in that car. (In my Honda Fit it’s bottom right, in my instructor’s Mazda it was bottom left.

In a small study conducted in 2006, participants in a simulation study reported that they were more attentive while driving in manual transmission mode but real studies are hard to find.

About a month after completing five lessons (two per week) and then practicing a small handful of times with my boyfriend in the passenger seat, I still tend to turn the wheel to the right a little when I shift as if I’m trying to change gears with the steering wheel. It’s a lot to remember.

I’ve read in many books that learning a new skill creates new neuro-pathways. Here’s a quote from an article in Fast Company. It refers to Tara Swart, a senior lecturer at MIT, and her book Neuroscience for Leadership:

If you want to keep your brain agile, you’re going to have to hone in on parts of the brain that you use less frequently, says Swart. And this new task has to be so challenging that you’ll feel mentally and physically exhausted after practicing the task because you’re forcing your brain to work in ways it’s unaccustomed to. This is the only way you’ll actually grow new neurons strong enough to connect with existing neurons, forming new pathways.

Mentally exhausted? Yep. Working in a way that my brain is unaccustomed to? Yep.

I’ve experienced these while learning to drive and practicing. After each initial lesson, those in years past, I was done and drained. It’s one of the reasons that I wasn’t keen on more lessons.

I’ve been writing Facebook status updates called “Adventures in Stick Shift Driving.” I share them below.

What is executive function? The term comes up a lot in the ADHD world. I aim to be a resource, and so I thought I should write a post about it to which to refer people.

What began in the field of neuroscience is now a widely used concept to explain conscious functioning. Executive function is a set of cognitive skills that depends on three types of brain function. These skills are controlled by the part of the brain known as the frontal lobe:

-Working memory governs our ability to retain and manipulate distinct pieces of information over short periods of time. Fact: My long-term recollection is better than my short-term memory. I can recall moments from years ago that seem insignificant or the phone number that I haven't had in over 22 years. Yet, I often can't recall what I ate for dinner the day before.

-Mental flexibility allows us to be able to think about something in more than one way. It helps us apply different rules in different settings and it helps us to sustain or shift attention in response to different demands. For example, while cooking or driving or taking care of multiple children.

-Self-control/inhibition control enables us to set priorities, start tasks and stay focused on them. Think schoolwork or work projects. This means that it enables us to ignore distractions and resist temptation. For example, the distraction of Facebook or Netflix instead of writing a blog post about executive function. Right now, executive functioning skills are keeping me in this blog post window.

Really, they come down to mental control and self-regulation.

Self-control includes emotional regulation and control. If we have difficulty regulating our intense emotions, then our executive function is also compromised. To put it in basic terms, when we are upset, it's more difficult for us to think clearly. Think about times that you've been in a heated argument, or when you got frustrated while trying to learn something, or you felt you were in trouble.

Last month, along with posting to Medium on a regular basis, I was also answering questions on Quora. My first answer received 99 upvotes and 7.9k Views, the most popular response to the query. Here is that question and answer:

Q: How can I treat my ADHD without drugs?

A:

I’ve never been on meds. I was diagnosed in my early 20s after my formal education was complete. Up until then, here’s how I coped:

I observed that I wasn’t like everyone else, and I attempted to be.

When I did school assignments, it helped to write about a topic that I was interested in. If I had a choice of topic or could take an angle/point of view that interested me, I performed better. When I did English assignments about books that I enjoyed, I got better grades.

When studying for tests and exams, I highlighted, took notes, drew asterisks and got colourful with my notations. Having highlighters in all colours and those 4-colour pens made a difference in remembering information. I took notes in margins and annotated those. (I was in high school as the internet was coming of age and when few people had laptops. Laptops were made by Apple.)

Photo by William Iven on Unsplash

After I got diagnosed, I was recommended the book The ADD Nutrition Solution by Marcia Zimmerman. 20 years later I’m still suggesting that book. It changed my life. Two months into following the plan I noticed myself maintaining eye contact during an interview and thought, “Huh, I can maintain eye contact now.”

Everybody’s needs are different, but there are some basics for ADD management, some of which I had in memory and some of which I pulled off my bookshelf. Starting with nutrition and nutrients:

Nutrition and nutrients

Consume lots of good fat. I cannot emphasize high-quality fats enough. Most of the brain is made of fat. It’s essential. Omega 3 essential fatty acids are important for everyone and were probably the biggest game changer for me. This is why food lifestyles such as the ketogenic diet are good for brain health issues. Don’t think that it’s a silly weight loss fad. Keto has been helping people with seizures for decades. Its popularity has recently soared because it works, and then food faddists starting following it.

Probiotics. A healthy gut is necessary for a healthy brain. The gut microbiome is sometimes referred to as the “second brain.” 95% of the body's serotonin is produced by the gut nerve cells, and every class of neurotransmitters found in the brain is also found in the gut. Microbiota and nerve cells in the gut produce more than 40 neurotransmitters. Also, most of your immune system resides in your gut. I recently wrote a detailed blog post about it.

Zinc. Zinc nourishes the entire brain. It also helps create a lot of the neurotransmitters that help relay messages between neurons. The production of melatonin depends on zinc. It also helps with immune function. Lots of us with brain health issues have problems with inflammation of the brain and inflammation is an immune response. In studies of children, those with the lowest blood levels of zinc had the highest levels of inattention, distractability, hyperactivity, impulsivity and other symptoms.

Vitamin B6. It helps form dopamine. In one study of children with ADHD that was done in 1979, vitamin B6 was as effective as Ritalin at controlling symptoms. (Source: A study published in Biological Psychiatry and referenced in James Greenblatt’s recent book Finally Focused). In other studies on adults cited in that book, vitamin B6 improved attention and decreased other symptoms. This said, if you’re already taking Ritalin do not stop just because someone on the internet (me) told you about vitamin B6. If you’re interested in stopping meds, talk to your doctor. I am not a doctor.

Carnitine may help regulate dopamine and ADHD.

Vitamin D is a neurotransmitter precursor that helps produce serotonin.

Depending on symptoms and type of ADHD, different neurotransmitter precursors might help. Studies show that the ADHD brain blocks tryptophan and that low levels of GABA cause impulsivity. So, GABA might help people who are impulsive and hyperactive. L-tryptophan helps with sleep problems and anxiety.

Watch the sugar and caffeine. Low sugar or no sugar. Be honest with yourself about whether or not you can tolerate caffeine. Caffeine helps some people with ADD, providing better focus and clarity. Some people find that caffeine causes anxiety. Some go through periods of each. Some coffee drinkers can have it at night and still fall asleep easily. Caffeine is a drug. If it helps you, go for it.

The rest

Physical activity. Years ago, a gym teacher in the U.S. initiated a program in which students elevated their heart rate before the start of school. As a result, it increased attention and learning. Other schools and school districts followed.

Adequate sleep. Our brains need the recovery time.

Routine. Try to keep your necessary items in homes (e.g., keys always in the same place) and try to stick to a schedule. If you have a list of activities that you do every morning, you’ll be more likely to remember if it’s routine.

Environment: Determine the best environment for you and try to maintain it. You might need absolute quiet or a bit of background noise.

Mental exercises: Puzzles, meditation, anything that teaches focus.

Self-compassion. It’s easy to hate ourselves for certain qualities. Also, we tend to be more emotional, and our brains amplify situations. Not everyone with ADD will do this. There are different types of ADD that affect different parts of the brain. Every human on the planet benefits from self-compassion and love.

I have a whole system that I called PRIMED for bringing ADD into balance. I created it based on my own needs, and I’ve helped others. (Contact me to learn more!)

Remember, ADHD is a brain health issue. A healthy brain is vital. Medications work on the symptoms, but you need to keep your brain healthy, just like your body. Keep yourself healthy rather than deal with it when you already feel like crap. Furthermore, a healthy body helps maintain a healthy brain.

Seek out the two books I mentioned above. Also, check out Daniel Amen’s website and his books about ADD. These are the three resources that have had the most significant impact on me.

Bonus tip for my blogs: I find that my most focused, productive days begin with a morning run, followed by a big glass of water (at least a half litre), and then a coffee blended with coconut milk (good fat) and Four Sigmatic Lion's Mane Elixer. The tagline for this product: “Like a hug for your brain”. Sometimes I double-fist coffee and a protein-packed smoothie. Want to try the Lion's Mane Elixer? Click that link and you'll be given 10% off. If you don't see the 10% off at checkout, enter code loveyourbrain. (Affiliate link.)

I talk a lot about my upcoming programs, but what I've never mentioned is that I'm also looking for a job for stable income. If I have stable income I can be a better coach because I'll have the income to invest in myself and my business, and I'll be able to give back by investing in other peoples' programs so I can keep learning and helping. I only apply to roles that appear to be a cultural fit with pay that matches my experience and cost of living. I want a position that's engaging with the right amount of challenge, where I'll be able to get feedback but also have autonomy. I like working with teams and collaborating, but also being able to do my part on my own. I want to be a rock star. I want to shine. I want to help. I recently posted this to LinkedIn:

I want a space where I either have cubicle walls OR a space I can go when I need to work alone if I'm in an open-concept office. A window seat for natural light would be nice, but not necessary. I need these things because I'm easily distracted, and I experience sensory issues. I prefer a physical barrier between myself and co-workers. I like to put calendars and other visual aids up on walls. It helps my productivity. I'm capable of hot-desking if my laptop is lightweight.

Something like this looks nice but can cause me anxiety:

Photo by Annie Spratt on Unsplash

One of the reasons for this post is that I've directed potential employers to this site as a writing example. It could be a risky move. I don't want potential employers – or clients – to worry that I'm a liability. ADHD isn't a red flag. It has benefits!

Here are some of the benefits of ADHD

Hyperfocus

One common characteristic of people with ADD/ADHD is the ability to hyperfocus. Many scientists, artists, writers and entrepreneurs have been very successful because of their ability to focus for hours. See examples below.

Bright and creative with different perspective

We tend to be intelligent and creative. We look at things differently than others do. We spend a lot of time in our heads. We're persistent. I think entrepreneurship appeals to people with ADD/ADHD because we're full of ideas and prefer to create our ideal work environment without burdening employers. I suspect that writing is often a career choice because of our creativity. We spend a lot of time in our heads. We create stories. We work out problems.

Albert Einstein is said to have had ADD, although this label that didn't exist during his lifetime.

Compassion and empathy

We tend to be compassionate and empathetic. These are useful when collaborating with co-workers or stakeholders and when communicating with clients. I'm certainly empathetic.

Hard work to maximize potential

We work hard to compensate for our “weaknesses,” and we've found ways to do so. For example, while “attention to detail” is one such weakness, people whom I've worked with and for have observed that I have an eagle eye for editing. I notice when the font face is inconsistent and when there's an extra space. As long as I take my editing work to a quiet place with no distraction, I edit well. To me, editing is like a fun puzzle. Find all of the errors! I'm extremely organized because I need to be. Everything gets written down. If it's not on my calendar, it doesn't exist. I have friends with ADD who share this experience.

Self-awareness

We're self-aware. We're aware that we're different than others. Some of us understand that we're neurodiverse, even if we don't know that word (I only recently learned it).

In the last year, I stopped fearing being a burden. I've taken it upon myself to help fight the stigma. Creating awareness is why I changed the mission of this website. When my previous full-time job made my ADHD flare up after it had laid dormant for months, I discussed it with my manager. It was the first time I had ever raised the issue with a manager. In the past, I chose to “suck it up.” My manager was sympathetic and unsuccessfully advocated for me. Because I was under contract with an agency, the system wasn't on my side. I accepted the job offer because I was qualified and needed income, but I quickly discovered that it was a poor fit.

Lessons learned while working for that company are helping me in my current job search. I have a better understanding of my own needs, which allows me to maximize my productivity and value. I'm an asset because I know what works for me and what doesn't. Being honest about it benefits my (future) employer and me.

I also picked up some new experience and skills. For example, I learned how to plan and host a Twitter chat.

It seems that people choose careers for reasons related to ADD (or, their careers choose them).

On side-gigs, side-hustles and the like

I am fully confident that I can support a small (4-6) roster of 1:1 clients and/or a couple of client groups while managing a 40-hour/week job. SO many people have side hustles these days, and if anyone can do it, it's someone with Attention Deficit Disorder. I have systems in place. I have multiple calendars. I can prioritize. For years I freelanced as a social media specialist while I had a full-time job. I collaborated with one or two clients at a time. I always preferred to keep my client roster small so that I could devote more attention to each. I think that that's beneficial for relationship management, ADD or not.

So, if you're here because I've applied for a job at your company, let's chat! I determined that you and I were a good fit based on what I knew about the role and the company. I'm a good judge of such things. If you're here without me having applied to your company, let me know if you've got anything. I'm looking for either a transit-friendly job in Toronto or remote work.

If my memory is correct, I first heard the term “neurotypical” while watching the TV show Atypical*, about a family with a teenage son with Asperger's. Although I understood what the word meant, I looked up the definition for the sake of this post.

Google said, “not displaying or characterized by autistic or other neurologically atypical patterns of thought or behavior.”

Urban Dictionary told me that it's a word “used to describe a person who has a typical brain. This not only includes non-autistic people, but also people without mental illnesses, intellectual disabilities or any other neurological illness or disorder such as epilepsy or brain tumours.”

Between first being exposed to the term “neurotypical” and googling it, I saw it used in older articles about ADD and ADHD and other brain health conditions.

I quickly decided that I don't like the word. To me, classifying people as “neurotypical” or “atypical” indicates individuals either have a “normal” (neurotypical) brain or an abnormal one. While there is such a thing as a “healthy brain” and brain health is one of my primary areas of focus these days, I've always been bothered by classifying people in ways that marginalize them. We are all different, yes, and I believe in embracing those differences, but “neurotypical” and “atypical” make me uncomfortable.

However, humans see the world through words and classification, and I understand that it's easier to make sense of the world that way.

If a healthy brain is neurotypical and AD(H)D, depression, Alzheimer's, dementia, anxiety are all brain health issues, then people with those conditions are atypical.

Mental health=brain health

Mental health and brain health are not the same, but they are interconnected, and people often miss the “brain health” part of the picture.

A post shared by Andrea Toole (@findinghealthwellness) on May 10, 2017 at 8:36am PDT

Labels and self-identifying

Perception is interesting. Someone contact me twice via contact form on my website, both times referencing that I write about disabilities. Except, I don’t write about disabilities. At least, I don’t think I do. My reaction to those two emails was to recoil and think, “Has this person read my website? I don’t write about disabilities.” It’s possible that she didn’t read my website (it’s common for bloggers to receive pitches from people who haven’t read their blogs). However, it’s also possible that some people could perceive it that way.

It's not how I define myself. I don't consider myself disabled because I have ADHD. I have a different brain. That said, if I had a brain scan that was compared to the scans of others, my brain activity would differ. Of this, I have no doubt.

I was born this way, and symptoms may have been intensified by activities such as antibiotic use when I was a child (though antibiotics were probably necessary, we didn't know about probiotics), eating foods that aren't good for my gut, and other factors. The mind and body are one, which I'll discuss in my next post.

I have what I call ADD “flare-ups” when the symptoms are predominantly active, and then there are times when the symptoms are dormant. I created my PRIMED system of AD(H)D management based on what makes mine flare up and what keeps it dormant.

My different brain also contributes to anxiety and depression as well as candida flare-ups, which are common in people with AD(H)D. Fungal infections and yeast overgrowth affect the brain. Clearing that stuff up can go a long way to reduce or eliminate symptoms of ADD, depression, anxiety and other brain/mental health issues. Again, brain-body connection.

When I use the phrase “brain health” I'm talking about the physical brain. It's neurological. It involves neurotransmitters. When I talk about “mental health” it's less tangible. It's more the affect of stress, which can be environmental, social or physical.

A healthy brain relies on the right nutrition, feeding it what it needs both in the form of whole foods and supplements, and water. It relies on physical exercise. A healthy mind is aided by thoughts, brain exercises, meditation, routines and the right environment. Both a healthy brain and a healthy mind rely on downtime and rest.

You'll learn more about this from me over time. Without intending to, I've just described my PRIMED system for bringing your life into balance so that you can achieve harmony.

There's more to come.

Taking it back to the term “neurotypical”

As I was finishing this post I came across a term that I do like. I will save that for another day.
(Here is that post.)

*Find it. Watch it. I don't know how realistic it portrays Asperger's because I don't have experience with it, but by the end, I saw it as a show about a family. Asperger's was secondary.